Objective: The purpose of this study was to evaluate and compare the association of job stress and working with video display terminal (VDT) to musculoskeletal symptoms of the neck-shoulder which were most common in white-collar workers. METHODS: From 122 workplaces, 1,790 white-collar workers with no trauma, and no history of musculoskeletal disease were selected for the study. The questionnaire survey included general characteristics, work related characteristics, Job Content Questionnaire (JCQ) and musculoskeletal symptoms. Multiple logistic regression, adjusted for age, smoking status, drinking habit, housekeeping, work time, job tenure, and work-load change, were used to evaluate the effects of job stress and VDT-work on the symptoms. RESULTS: The prevalence of neck-shoulder symptoms was overall 24.3% overall. The prevalence odds ratio of job demand (high/low) to neck-shoulder symptoms, adjusted for general and work-related factors, was 1.56 (95% confidence interval 1.12~2.17), and that of job strain (high strain/low strain) was 1.72 (1.07~2.79). However, VDT-work was not associated with neck-shoulder symptoms in the multiple logistic regression model. CONCLUSIONS: To prevent musculoskeletal disorders in white-collar workers, it is important to consider psychosocial factors such as job demand and job strain, as well as VDT-work.
Computer Terminals ; Drinking ; Housekeeping ; Logistic Models ; Musculoskeletal Diseases ; Neck* ; Odds Ratio ; Prevalence ; Psychology ; Questionnaires ; Shoulder* ; Smoke ; Smoking

BACKGROUND: The educational assessment of residents is very important in order to check their knowledge and to improve their ability. In case of family practice, the residents spend most of their training time in outside rotations with other specialities. Therefore, they are requested to be evaluated by each specialist after each rotation. To give more accurate assessment, we surveyed directly our family practice residents and family practice faculties. METHODS: A questionnaire was sent to family practice residents and family practice faculties in 116 hospitals from May to June 2006. The response rate was 29% and 78%, respectively. RESULTS: Among the total, 70.2% of family practice residents thought an assessment is necessary, but only 51.7% were evaluated. Overall, 90.4% of family practice faculties knew about the assessment of residents made by other specialists, and only 56.7% of faculties requested other specialists to assess their family practice residents. CONCLUSION: Most of the family practice residents and their faculties knew the need for assessment, but they complained there were no objectivity and the assessment tool was lacking. In order to solve this problem, it is urgent to develop a unified form and guidelines of assesment.
Educational Measurement* ; Equidae ; Family Practice* ; Humans ; Specialization ; Surveys and Questionnaires

OBJECTIVE: This study was performed to evaluate relationship of burdened work and musculoskeletal symptoms in small-to-medium sized enterprises. METHOD: After a questionnaire survey was administered to 9,950 workers in 122 workplace, 7,626 workers(76.6%) were finally selected for the study analysis. Industrial hygienists visited 122 small-to-medium sized enterprises to investigate the presence of burdened works within the workplace. The selection of jobs with significant burden was based on the Ministry of Labor's recent notification in 11 types of job description associated with musculoskeletal disorders. The subjects of this study were then divided into three categories. 1) non-burdened white collar workers, 2) non-burdened blue collar workers, and 3) burdened workers (include some VDT workers). Multiple logistic regression was used to evaluate the relationship between burdened work and musculoskeletal symptoms. RESULTS: The burdened workers reported significantly more musculoskeletal symptoms than non-burdened white collar workers and non-burdened blue collar workers(OR:1.57, 95% CI: 1.314-1.875). There was no significant difference in reports of musculoskeletal symptoms between non-burdened white and blue collar workers. CONCLUSION: To prevent or diminish musculoskeletal disorders in small-to-medium sized enterprises, we need to better manage burdened works.
Job Description ; Logistic Models ; Questionnaires

PURPOSE: Tubeless percutaneous nephrolithotomy (PNL) remains a challenging technique for the surgical treatment of staghorn renal calculi. Our study was designed to compare surgical outcomes between conventional and tubeless PNL. MATERIALS AND METHODS: We retrospectively enrolled consecutive patients who underwent conventional or tubeless PNL under general anesthesia performed by a single surgeon (H.J.) for the treatment of staghorn calculi between 2003 and 2012. All patients were divided into two groups: group 1 included patients who underwent conventional PNL and group 2 included patients who were managed by tubeless PNL for the treatment of staghorn calculi. Preoperative and postoperative parameters were analyzed between the two groups, including age, stone burden, complications, any interventions, and duration of hospital stay. RESULTS: A total of 165 patients (group 1, 106; group 2, 59) were enrolled in the study. No significant differences in age, sex, body mass index, or stone laterality were observed between the two groups. The mean stone burdens (+/-standard deviation) of group 1 and group 2 were 633.6 (+/-667.4) and 529.9 (+/-362.8), respectively (p=0.271). The postoperative stone-free clearance rate was higher in group 2 (78.0%) than in group 1 (69.8%); however, the difference was not clinically significant (p=0.127). In addition, no significant differences in postoperative complications, including fever, bleeding, infection, or additional interventions, were observed between the two groups. CONCLUSIONS: Our results demonstrated that tubeless PNL has the same effectiveness and safety as conventional PNL in the treatment of staghorn calculi. Tubeless PNL may be feasible for managing renal staghorn calculi.
Anesthesia, General ; Body Mass Index ; Calculi ; Fever ; Hemorrhage ; Humans ; Kidney Calculi ; Nephrostomy, Percutaneous ; Postoperative Complications ; Retrospective Studies

BACKGROUND: The sleep quality of subway drivers who work in the dark underground with an rotating shift system is generally poor, which can degrade the quality of a worker's life. This study examined the relationship between the sleep quality of subway worker and shift work by comparing three shift systems (rotating shift system, a three day shift system, and no-shift system). METHOD: Questionnaires including The short form of the Korean Occupational Stress Scale (KOSS), Pittsburgh Sleep Questionnaire (PSQI), the worker's age, gender, job type, accident, near miss and shift system were given to a total of 1010 workers. The results of 759 qualified questionnaires (75.15 %) were analyzed using the SPSS (ver 12.0) program. RESULT: The highest level of job stress was found among those working a rotating shift system followed by three shift system and no-shift system. The mean sleep quality score in the rotating shift workers was 5.1 (SD+/-3.2), which was greater than the sleep symptom score (5). 34.8% of rotating shift workers suffered from sleep symptoms. The sleep quality score by shift-work was significantly different. High job demand, strong external locus control, the experience of a near miss or an accident in the workplace during previous year has an adverse affect on the sleep quality. The sleep quality improved in case of a change into a no-shift system or a strong internal locus control. CONCLUSION: A rotating shift system is more harmful to the quality of sleep in subway workers than a 3 shift system or no-shift system. In addition, job stress, personality, near miss and the experience of an accident affect the sleep quality of subway workers.
Questionnaires ; Railroads

BACKGROUND: This study was conducted to survey the current status of family medicine residency programs and to evaluate the difficulties in training of the curriculums. METHODS: Questionnaires on residency programs were sent to all the centers of residency programs by mail in April 2006. The questionnaire included detailed characteristics of residency programs, curriculum schedule, reasons for failed specific curriculum, and review and measures by the program center and the Korean Academy of Family Medicine to resolve problematic curriculums. RESULTS: A total of 113 residency programs responded. Among the 93 residency programs except for the 20 subsidiary hospitals, inadeguate subjects were mainly dermatology (12 programs, 12.3%), psychiatry (6 programs, 7.5%), ophthalmology (5 programs, 7.1%), and otolaryngology (5 programs, 7.1%). Training rejection rate was higher in dermatology (13 programs, 14.4%), radiology (11 programs, 13.1%), gastrofibroscopy (8 programs, 9.5%), and psychiatry (5 programs, 6.2%). Emergency me-dicine in 4 programs and general surgery in 3 programs had a longer duration of training than initially planned. Difficulties in training some subjects were due to failed establishment of specific curriculums in non-university hospital. Commonly established clinics were health promotion center, obesity clinic, smoking cessation clinic, geriatric clinic, stress clinic, and clinical nutrition clinic. Family medicine center programs included gastrofibroscopy, obesity, smoking cessation, geriatrics, hospice care, and evidence-based medicine. CONCLUSION: There is repeated demand for taking measures to promote better curriculum in the nation-wide view of family medicine. Dermatology, radiology, psychiatry, and otolaryngology were the subjects difficult to receive training. Measures to strengthen the weak subjects are urgently needed.
Appointments and Schedules ; Curriculum* ; Dermatology ; Emergencies ; Evidence-Based Medicine ; Geriatrics ; Health Promotion ; Hospice Care ; Humans ; Internship and Residency* ; Korea* ; Obesity ; Ophthalmology ; Otolaryngology ; Postal Service ; Smoking Cessation ; Surveys and Questionnaires

BACKGROUND: This study was conducted to survey the current status of family medicine residency programs and to evaluate the difficulties in training of the curriculums. METHODS: Questionnaires on residency programs were sent to all the centers of residency programs by mail in April 2006. The questionnaire included detailed characteristics of residency programs, curriculum schedule, reasons for failed specific curriculum, and review and measures by the program center and the Korean Academy of Family Medicine to resolve problematic curriculums. RESULTS: A total of 113 residency programs responded. Among the 93 residency programs except for the 20 subsidiary hospitals, inadeguate subjects were mainly dermatology (12 programs, 12.3%), psychiatry (6 programs, 7.5%), ophthalmology (5 programs, 7.1%), and otolaryngology (5 programs, 7.1%). Training rejection rate was higher in dermatology (13 programs, 14.4%), radiology (11 programs, 13.1%), gastrofibroscopy (8 programs, 9.5%), and psychiatry (5 programs, 6.2%). Emergency me-dicine in 4 programs and general surgery in 3 programs had a longer duration of training than initially planned. Difficulties in training some subjects were due to failed establishment of specific curriculums in non-university hospital. Commonly established clinics were health promotion center, obesity clinic, smoking cessation clinic, geriatric clinic, stress clinic, and clinical nutrition clinic. Family medicine center programs included gastrofibroscopy, obesity, smoking cessation, geriatrics, hospice care, and evidence-based medicine. CONCLUSION: There is repeated demand for taking measures to promote better curriculum in the nation-wide view of family medicine. Dermatology, radiology, psychiatry, and otolaryngology were the subjects difficult to receive training. Measures to strengthen the weak subjects are urgently needed.
Appointments and Schedules ; Curriculum* ; Dermatology ; Emergencies ; Evidence-Based Medicine ; Geriatrics ; Health Promotion ; Hospice Care ; Humans ; Internship and Residency* ; Korea* ; Obesity ; Ophthalmology ; Otolaryngology ; Postal Service ; Smoking Cessation ; Surveys and Questionnaires

Mercury occurs in various chemical forms, and it is different to health effects according to chemical forms. In consideration of the point, the evaluation of the mercury exposure to human distinguished from occupational and environmental exposure. With strict to manage occupational exposure in factory, it is declined mercury intoxication cases by metallic and inorganic mercury inhalation to occupational exposure. It is increasing to importance in environmental exposure and public health. The focus on the health impact of exposure to mercury is more on chronic, low or moderate grade exposure—albeit a topic of great controversy—, not high concentration exposure by methylmercury, which caused Minamata disease. Recently, the issue of mercury toxicity according to the mercury exposure level, health effects as well as the determination of what mercury levels affect health are in the spotlight and under active discussion. Evaluating the health effects and Biomarker of mercury exposure and establishing diagnosis and treatment standards are very difficult. It can implement that evaluating mercury exposure level for diagnosis by a provocation test uses chelating agent and conducting to appropriate therapy according to the result. but, indications for the therapy of chelating agents with mercury exposure have not yet been fully established. The therapy to symptomatic patients with mercury poisoning is chelating agents, combination therapy with chelating agents, plasma exchange, hemodialysis, plasmapheresis. But the further evaluations are necessary for the effects and side effects with each therapy.
Chelating Agents ; Diagnosis* ; Environmental Exposure ; Humans ; Inhalation ; Mercury Poisoning ; Mercury Poisoning, Nervous System ; Occupational Exposure ; Plasma Exchange ; Plasmapheresis ; Public Health ; Renal Dialysis